PowerPointesitys

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2nd ITHC Conference, Portland, Oregon, 13-14
September 2004 How can African healthcare
institutions get appropriate software? Sociotechni
cal research in the INDEHELAContext project
Mikko Korpela, DTech (Information
Systems) Research Director, Healthcare
Information Systems RD Unit, University of
Kuopio, Finland and Lyn Hanmer, Retha de la
Harpe, Esselina Macome, Anja Mursu, H. Abimbola
Soriyan www.uku.fi/tike/indehela
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• Contents of the presentation
• Motto and concepts
• Research questions and objectives
• Prior research INDEHELA-Methods, 19982001
• Research approach INDEHELA-Context, (2003)
  20042007
• Research plans Nigeria, Mozambique, South
  Africa, Finland
• Discussion and conclusion

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Motto
Technology should be considered appropriate
when its introduction into a community creates a
self-reinforcing process internal to the same
community, which supports the growth of the local
activities and the development of indigenous
capabilities as decided by the community
itself Pellegrini, Appropriate Technology Conf.
1980, p. 1, emphasis added How can African
healthcare institutions get appropriate
software How can African healthcare
institutions get software whose introduction
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• Concepts Information system vs. software system
• Information system The processes, people and
  technologies (manual and computer-based) of
  information management within an organization or
  an activity i.e., a social system with embedded
  technology
• Software system (software application) is a key
  component of computer-supported information
  system hardware is the same anywhere, software
  determines the functionality
• Work activity A number of people working on a
  shared object (e.g., a patients health problem),
  not necessarily in the same time and place, to
  produce a joint outcome (e.g., health
  improvement) a process, its actors, their means
  and instruments, coordination of the process

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Basic research setting and units Activities,
services, organizations, society
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Research questions and objectives 1
Q1. How can African healthcare facilities and
healthcare management get software applications
that enable them to use ICT to provide better
healthcare services for the people? (the main
research question)
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Research questions and objectives 2
Q2. What are the potential roles of local
information systems (IS) professionals in the
software service chains?
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Research questions and objectives 3
Q3. What are the characteristics of appropriate
software?
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Research questions and objectives 4
Q4. How to ensure that computer-based information
systems in healthcare in Africa will be
sustainable and affordable, and will have a
positive long-term impact on healthcare services?
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Research questions and objectives 5
Q5. What kind of education of ICT professionals
and healthcare professionals is needed to support
these objectives?
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INDEHELA-Methods, 19982001 Methods for
informatics development for health in
Africa Overall objective Better service to
communities through better IS methods and better
IS education Endogenous process development
intervention by local actors, technology
acquisition instead of technology transfer
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• INDEHELA-Methods, 19982001
• Methods for informatics development for health in
  Africa
• Survey on 100 software companies Technically
  capable
• Survey on university education Major
  inadequacies
• Case studies in software companies and their
  clients
• MINPHIS (Made in Nigeria Primary-care and
  Hospital Information System) project in
  university, 14 years
• Analytical framework ActAD
• Tentative IS development methods, e.g. for
  sustainability

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• INDEHELA-Context, 2003 ? 20042007
• Socio-economic impact, sustainability and
  affordability in information systems development
  in and for Africa
• Conduct similar research in two more African
  countries
• Combine experience from 4 countries, compare
  contexts
• Test the results from previous studies in
  software companies
• Test the results from previous studies in
  university education

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Comparing results across contexts Generic model
of healthcare delivery system
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Information activities for healthcare delivery
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Generic healthcare management system
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Research plans Nigeria

• Researcher in charge Dr Abimbola Soriyan,
• Computer Science Dept., Obafemi Awolowo
  University, Ile-Ife
• Action research around MINPHIS Validate the IS
  development model of the previous phase by using
  it in expanding MINPHIS to primary care.
  Evaluate IS use in selected MINPHIS hospitals.
• Validate IS development methods in companies
  Collaboration with selected software companies
  and in-house software development units. Joint
  student projects.

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Research plans Mozambique

• Researcher in charge Dr Esselina Macome,
• Dept. of Math. and Informatics, Eduardo Mondlane
  Univ., Maputo
• Three potential sources of software
  software companies, in-house IT departments,
  NGOs Case study, focus group discussion with
  former graduates, analysis of District Health
  Management Information System (DHMIS) project,
  workshop with local companies
• The role of healthcare information management
  professionals Case study, evaluation of
  education in IS
• Education and training of ICT professionals
  Curricula and teaching materials to be revised
  with results from other parts

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Research plans South Africa

• Senior Advisor Prof Dewald Roode, IS Dept.,
  Univ. of Cape Town
• Researchers in charge Ms Retha de la Harpe,
• Business Informatics, Cape Peninsula Univ. of
  Tech., Cape Town
• Ms Lyn Hanmer, Medical Research Council, Cape
  Town
• Small-medium size medical practice (SMMP)
  Landscape model of stakeholders, data quality,
  customer orientation, continuing professional
  development, HIS development
• Analysis of DHMIS evolution From a local
  university-based project into a national and
  international network involving public and
  private sector
• Curriculum development IS education modules and
  materials revised in view of results from other
  parts

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Research plans Finland

• Senior Advisor Dr Mikko Korpela, HIS RD Unit,
  Univ. of Kuopio
• Researcher in charge Dr Anja Mursu,
• Dept. of Computer Science, University of Kuopio
• Comparison between contexts Collect and arrange
  results on activity/organization level from other
  countries for joint comparative analysis,
  identify linkages with wider societal, political,
  cultural and historical phenomena
• Education for international consultants IT for
  Development modules and training material to a
  Masters programme in International Development
• Appropriate software architecture Generic,
  adjustable framework architecture suitable of
  guiding the accumulation of a clearinghouse of
  interoperable software components

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Discussion and conclusion

• The development and acquisition of appropriate
  software is a deeply sociotechnical issue
• Network of collaborating, independent research
  groups, therefore each group will identify their
  own topics
• Collaborative network used for coordination and
  exchange diversity and autonomy regarded as an
  asset, despite risks of fragmentation and lack of
  common orientation
• Outcome should be a mosaic of empirical research
  on specific issues comparative analysis of
  contextual issues
• Research questions and high-level plans presented
  now for feedback and as an invitation to form a
  wider network

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Acknowledgements This presentation is based on
joint research in the projects INDEHELA-Methods
(1998-2001) and INDEHELAContext (2003,
2004-2007), funded by the Academy of Finland
grants no. 39187, 201397 and 104776. www.uku.fi/t
ike/indehela Health Informatics in
Africa www.helina.org Activity Analysis and
Development (ActAD) www.uku.fi/tike/actad